Despite advances in the management of advanced clear cell renal cell carcinoma (ccRCC), robust biomarkers for prognosis and therapeutic response prediction remain elusive. Fibroblast activation protein-α (FAP), a marker of activated cancer-associated fibroblasts (CAFs), has emerged as a potential indicator of tumor aggressiveness and resistance to systemic therapies in various solid tumors. This study evaluated the clinical relevance of stromal FAP expression in a cohort of 137 patients with advanced ccRCC and long-term follow-up. FAP immunohistochemistry (IHC) was performed on primary tumor specimens and correlated with key clinicopathological features, disease-free survival (DFS), overall survival (OS), and radiological response to first-line tyrosine kinase inhibitors (TKIs). A significantly higher percentage of FAP-positive CAFs was observed in primary tumors with high histological grade, extensive local invasion (pT3–4), and advanced clinical stage (NCCN stage III–IV). Stromal FAP expression was associated with shorter DFS and OS. Moreover, tumors lacking FAP expression were more likely to achieve complete response to TKI therapy as defined by RECIST criteria. These findings highlight the potential of FAP IHC as a prognostic and predictive tool in advanced ccRCC and support further clinical validation.

Traumatic dislocation of testis is a rare event. We report a case of traumatic testicular dislocation in a 27-year-old patient presenting a right inguinal lump in a context of acute alcohol abuse with transient global amnesia. There was a tender mass in the right inguinal region and right hemiscrotum. He ascertained a previous scrotal position of both testes. The Doppler ultrasound confirmed the diagnosis of a dislocated right testis in right inguinal canal and surgical reduction and orchidopexy was performed. It is necessary to perform a complete physical examination in a trauma patient, early detection and management are both essential to preserve normal spermatogenic function.

Urachal sinus is a rare type of urachal abnormality. It happens because of blind focal dilation at the umbilical end and has increased risk of infection. We report the case of a 23-year-old female with abdominal pain and umbilical discharge. Ultrasound detected a possible infected urachal sinus which was initially treated with antibiotic therapy. Urachal sinus excision and laparoscopic bladder raffia was later performed with no recurrence at present. Diagnosis of this pathology is essential given that surgery is curative and avoids complications such as neoplastic transformation.

Anal mucinous adenocarcinoma is a rare entity, representing approximately 5-11% of all anal cancers. Sometimes it is associated with chronic inflammation of long-standing anal fistula as it may occur in patients with Crohn's disease. In this case, cancer usually goes unnoticed owing to the inflammatory disease; therefore, a degree of uncertainty surrounds initially the diagnosis. We report a case of a 62-year-old man with A2 L3 B3p Crohn’s disease who also presents a perianal mucinous pseudocyst that is removed. Histological examination reveals a mucinous pseudocyst. At the two-year follow-up, we observe the recurrence of the cyst within an anal fistula. Scheduled non-oncologic surgery is performed with resection of the cyst and tutoring of the fistula with seton. Histological examination reveals mucinous adenocarcinoma. With no evidence of metastasis in the extension study, the patient is subjected to radical surgery with abdominoperineal resection. After 3 years and 11 months, a follow-up is carried out and there is no evidence of recurrence or distant metastasis. Mucinous adenocarcinoma within an anal fistula is a challenge in its diagnosis and its treatment due to the anecdotal nature of the cases. Given the high local risk of recurrence, radical surgery is recommended, occasionally associating neoadjuvant chemoradiotherapy if the neoplasm is locally advanced.

Ureteral amyloidosis is a rare entity and of interest to urologists, hematologists, radiologists, and pathologists because it mimics urothelial cell carcinoma clinically, endoscopically and radiologically. A pre-operative ureteroscopy or surgical biopsy is required, and it is essential to exclude systemic amyloidosis.